Jake Good

Forever FOAMed enthusiast - Loma Linda alumni - FFPM 🚒🚑 #TeamFOAMFrat

[armyemdoc @armyemdoc]

Is ketamine a wolf 🐺 in sheep's 🐑 clothing?

Ketamine is a weird drug. It is a direct myocardial depressant, yet that is offset by the adrenaline surge it causes, oftentimes with transient hypertension and tachycardia. There is a theoretical risk of using the drug in someone that is in "catecholamine depleted," yet there is no definition of this clinically.

The CRM is a well-validated algorithm that assesses DO2. In this graph, you can see the spike in BP and HR after ketamine, yet the DO2 (red line, the thing that actually matters) is unchanged.

https://t.co/BjUe44x7rg

#emergency #emergencymedicine #foam #foamed #foamcc #army #armymedicine #armyemdoc #meded #icu #criticalcare #airway #anesthesia #prehospital #ems #medic #trauma #shock #resuscitation #medx #medtwitter #medairway #medairwaytwitter #airwayx

[Sahil Bloom @SahilBloom]

I can't stop thinking about this question:

Are you willing to sprint when the distance is unknown?

In 2021, Georgia Tech strength coach Lewis Caralla delivered this epic speech to the football team.

If it doesn't get you motivated, you may need to check your pulse...

He opens with a few harsh truths:

• Winning isn't loyal to you
• Winning doesn't care about you
• Winning doesn't care how sore you are
• Winning doesn't care how hard you work
• Winning doesn't care how much sleep you get

But it's his question that stuck with me:

Are you willing to sprint when the distance is unknown?

The willingness to sprint with no clear view of the finish line is rare.

It requires two things:

1. A deep belief in one's self
2. A deep belief in the mission

If you have 1 but not 2, you won't be able to do it.

If you have 2 but not 1, you won't be able to do it.

You need both.

In my observation, the greatest things in life are accomplished when you're willing to sprint when the distance is unknown:

The sprint to care for your loved ones in their time of need.

The sprint to build something meaningful.

The sprint to serve others and create positive ripples in the world.

Goal: Find those rare things in life that you're willing to sprint for when the distance is unknown.

That, to me, is the definition of winning.

"And why chase winning? Because the only thing that's guaranteed in life if you don't chase it is losing."

[Core EM @Core_EM]

Dizziness is a notoriously tricky chief complaint to work up in the ED. Let’s review one of the most up to date guidelines on how to approach it.

🧵 1/8 #MedEd

[Jace Mullen @_JaceMullen]

I see a lot of unnecessary panic in the peri-intubation period surrounding a misunderstanding of SpO2, and specifically pulse-ox lag.

I was going to write a neat tweetorial but then I found this that’s both quicker and better than anything I could do:

https://t.co/aKr06DHuX8

[Jake Good @JakeGood11]

@le_chadd Spent about 7-8 years out in SoCal in EMS. Most FD’s assume the role in larger cities so not many opportunities for single role besides AMR in the Inland Empire.
Flight run mostly by Reach (Inland Empire) and air methods in OC.
Good luck out there! 😬

[Dr. Longissimus @DrLongissimus]

In honor of the new residency application cycle, I asked chatGPT to write a CT abdomen pelvis report using Gen Z lingo

[EMS Avenger @EMSAvenger]

The Lucas doesn't get tired? Are you sure about that? Seems that it gets tired A LOT. Tired of being in the right spot.

[Cliff Reid @cliffreid]

Stopping someone from bleeding to death requires many keys steps

Our team uses this cognitive aid

Page 1 covers general measures to guide vascular access, haemostatic resuscitation, reversal of anticoagulation, and optimising of clotting

1/10

[Ben Abo @benabo]

@HandtevyMD Anything you expect the hospital to do especially in the first 45 minutes, should be done by EMS. Indont care if you pick the patient up across the street. They are calling for a reason. Help them.

[Jake Good @JakeGood11]

@Alastair__Ross @EM_RESUS Completely agree, Doctor! Is ketamine your induction choice in these patients? Or perhaps another agent or mental model you have for this scenario that you are willing to share? 🤓

[Jonny Wilkinson @Wilkinsonjonny]

Deresuscitation has become more and more ubiquitous within ICU practice. But what tools can we use to do it? Over the next 2 Tweetorials, i’ll explain some pharmacological methods. Focussing on the JICS mix!

My talk from #ACCS2023

#FOAMed #POCUS #FOAMcc #medtwitter

[Jake Good @JakeGood11]

@ss05cs 🤮🤮🤮

[Journal of Brown Hospital Medicine @BrownJHM]

Must know meds @SarahFoohey #Medtwitter #FOAMed

[Jake Good @JakeGood11]

@wftoon @steve_rinaldi @Jems @EMNews @EMS1 @NAEMT_ @EmergencyMedBMJ Current SCCM guidelines are calling for Abx administration within 1 hour… don’t see why this couldn’t fall under the EMS purview. NWA has ancef for traumatic wounds… would love to see this expanded

[Jace Mullen @_JaceMullen]

In honor of my return and sparked by the weird amount of HAPE i've been seeing here's some basics about High Altitude Pulmonary Edema, a 🧵...

(Are we still doing this?)

1/9

[OCFA @OCFireAuthority]

⚽️ It’s almost time for the #WorldCup! What do soccer and the fire service have in common? Find out in this video!

#footballunitestheworld #soccer #firefighter #skills 🎶Hayya Hayya (Better Together) | FIFA World Cup 2022™ Official Soundtrack

[Cliff Reid @cliffreid]

A Resuscitation Concept 🧵

The tension between stability and mobility

1/

[Lea Alhilali, MD @teachplaygrub]

1/They say form follows function! Brain #MRI anatomy is best understood in terms of both form & function

A #tweetorial on how to remember important functional #brain #anatomy

#meded #medtwitter #neurosurgery #neurology #neurorad #FOAMed #FOAMrad #radiology #medstudent #radres